A bipolar disorder disability lawyer can help if your short-term or long-term disability benefits have been denied, delayed or cut off.
An insurer may accept your diagnosis but argue that medication has stabilized your condition, you are functioning well between episodes or you can return to a less demanding job.
These arguments may overlook ongoing problems with concentration, judgment, sleep, energy and stress tolerance. They may also underestimate the risk and unpredictability of future depressive, manic or mixed episodes.
Samfiru Tumarkin LLP represents people with denied and terminated disability claims throughout Canada, excluding Quebec.
On This Page:
- How a Lawyer Can Help
- When to Contact a Lawyer
- Why Bipolar Claims Are Denied
- Evidence for Your Claim
- What Happens Next?
- Frequently Asked Questions
How Can a Bipolar Disorder Disability Lawyer Help?
A disability lawyer can review your insurance policy, medical evidence and denial letter to determine why the insurer refused or terminated your benefits.
A lawyer may help by:
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Explaining the definition of disability in your insurance policy
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Identifying weaknesses or inconsistencies in the insurer’s decision
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Determining what medical and functional evidence is missing
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Connecting your symptoms to the demands of your occupation
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Addressing limitations that continue between major mood episodes
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Challenging the insurer’s reliance on temporary improvement
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Communicating and negotiating directly with the insurance company
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Starting legal action when appropriate
Connecting Bipolar Symptoms to Your Job
A strong disability claim should explain why your condition prevents you from meeting the specific requirements of your occupation.
Depression may interfere with energy, motivation, attendance and concentration. Mania or hypomania may affect sleep, judgment, communication and decision-making. Medication can also cause fatigue, slowed thinking, tremors or dizziness.
A lawyer can help connect these limitations to the accuracy, reliability, judgment, communication and stress tolerance required by your job.
When Should You Contact a Bipolar Disorder Disability Lawyer?
Speak with a disability lawyer promptly if:
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Your short-term or long-term disability claim was denied
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Your approved benefits were later cut off
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The insurer says medication has stabilized your condition
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The insurer focuses on a temporary period of improvement
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Symptoms between major episodes are being overlooked
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Medication side effects are not being considered
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You are being pressured to return before your treatment team believes you are ready
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You are considering an internal appeal
You do not have to wait for another crisis, hospitalization or serious workplace incident before getting legal advice.
Do You Have to Appeal to the Insurance Company?
An insurer may invite you to submit an internal appeal after denying your bipolar disorder disability claim.
An appeal is not always the best option. The same insurance company that denied your claim will review it, and submitting similar evidence may produce the same result.
You may not have to complete the insurer’s appeal process before pursuing legal action. A disability lawyer can explain the available options and applicable deadlines.
Why Are Bipolar Disorder Disability Claims Denied?
An insurer may accept that you have bipolar disorder while arguing that the evidence does not prove you remain unable to work.
Common denial reasons include:
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The insurer says your mood is stable
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You have not recently required hospitalization
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Your medical records do not clearly explain your work restrictions
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The insurer focuses on a short period of improved functioning
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Medication side effects are overlooked
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The insurer says you can perform simpler, remote or less stressful work
The Insurer Says Your Condition Is Stable
Clinical stability does not necessarily establish that your work capacity has returned.
You may continue to experience fatigue, disrupted sleep, reduced concentration, difficulty making decisions or limited tolerance for ordinary workplace pressure.
The insurer should also consider whether returning prematurely could lead to worsening symptoms or another episode.
The Insurer Says You Previously Worked With Bipolar Disorder
A person may work successfully with bipolar disorder for years before the condition becomes disabling.
Episodes may become more frequent or severe, medication may become less effective, side effects may increase or previous coping strategies may stop working.
Your evidence should explain what changed and why regular employment is no longer sustainable.
The Insurer Focuses on a Lack of Hospitalization
Hospitalization is not required to qualify for disability benefits.
Many people receive treatment in the community. The relevant issue is whether your symptoms and limitations prevent you from performing your occupation—not where treatment occurs.
The Insurer Says You Can Perform Another Job
An insurer may accept that you can’t return to a highly demanding occupation but argue that you can perform simpler or remote work.
It should consider whether you can maintain the proposed job’s schedule, concentration, judgment, communication and productivity requirements consistently.
Your Benefits Are Cut Off After Two Years
Many LTD policies change their definition of disability after approximately two years.
The insurer may accept that you can’t perform your previous occupation but claim that you can work elsewhere.
Another occupation must be genuinely suitable given your symptoms, education, training, experience and ability to maintain reliable attendance and performance.
What Evidence Supports a Bipolar Disorder Disability Claim?
A bipolar diagnosis is important, but it may not explain everything the insurer needs to understand about your ability to work.
Helpful evidence may include:
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Records from your family doctor, psychiatrist and treatment team
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The frequency, severity and duration of mood episodes
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Hospital, emergency-room or crisis-treatment records where applicable
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Specific concentration, judgment, sleep and attendance restrictions
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Your medication history and treatment side effects
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A detailed description of your occupational duties
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Workplace accommodations and unsuccessful return-to-work attempts
Document Limitations Between Episodes
The insurer may focus on whether you are currently manic, severely depressed or in crisis.
Your medical evidence should also describe continuing limitations involving energy, cognition, sleep, judgment and stress tolerance during more stable periods.
Use Specific Work Examples
General statements that you can’t work may not provide enough detail.
Explain whether you struggle to meet deadlines, make decisions, communicate appropriately, manage competing demands or maintain regular attendance.
Document Failed Return-to-Work Attempts
A brief attempt to return does not necessarily prove that you are capable of sustained employment.
Document what duties you performed, which symptoms increased and why the return was unsuccessful.
What Happens After You Contact a Bipolar Disorder Disability Lawyer?
During an initial consultation, a disability lawyer may ask about your symptoms, treatment, occupation and the insurer’s reason for denying or ending your benefits.
The lawyer may review:
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Your denial or termination letter
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The definition of disability in your policy
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Your medical evidence and functional limitations
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Your job duties and accommodation history
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Important dates and potential legal deadlines
The lawyer can then explain whether the insurer’s decision may be challenged and what additional evidence could strengthen your case.
How Can a Bipolar Disability Claim Be Resolved?
Depending on the circumstances, a denied claim may be resolved through reinstatement of monthly benefits, payment of benefits previously withheld or a negotiated settlement.
There is no standard bipolar disorder disability settlement. The outcome depends on the policy, monthly benefit, medical evidence, prognosis, age and other circumstances.
Is There a Fee to Speak With a Disability Lawyer?
Samfiru Tumarkin LLP offers a free initial consultation for denied short-term and long-term disability claims.
There are no upfront legal fees. You only pay if we successfully resolve your disability claim.
Frequently Asked Questions About Bipolar Disorder Disability Lawyers
What does a bipolar disorder disability lawyer do?
A disability lawyer reviews your insurance policy, medical evidence and denial letter and helps challenge the insurer’s refusal to pay benefits.
When should you contact a disability lawyer?
Speak with a lawyer after your benefits are denied or cut off, before filing an internal appeal or when you are pressured to return to work against medical advice.
Can stable bipolar disorder qualify for LTD benefits?
Potentially. Continuing cognitive problems, fatigue, sleep disruption, medication effects and the risk of recurring episodes may prevent reliable employment.
Do you need to be hospitalized to qualify?
No. Disability eligibility is based on your symptoms and work limitations. Hospitalization is not required.
Do you have to appeal to the insurer first?
Not necessarily. An internal appeal is only one possible option. Speak with a disability lawyer before deciding how to challenge the denial.
Can a lawyer help before your benefits are terminated?
A lawyer may provide advice when the insurer requests additional information, schedules an assessment or warns that your benefits may end.
How long do you have to challenge a denial?
Legal deadlines apply and vary by province, policy and circumstances. Get legal advice promptly to protect your options.
Speak With a Bipolar Disorder Disability Lawyer
Managing recurring mood episodes, treatment and workplace pressure is difficult enough. You should not have to fight an insurance company alone while facing financial uncertainty.
Samfiru Tumarkin LLP represents people with denied and terminated disability claims throughout Canada, excluding Quebec.
Some members of our legal team previously worked for insurance companies. We understand why mental health disability claims are challenged and what evidence may be needed to dispute a denial.
For more information about eligibility and available benefits, read our guide to bipolar disorder disability claims in Canada.
Contact us for a free consultation if your short-term or long-term disability claim has been denied or cut off.